由药品不良反应/事件看我院抗菌药物临床应用药物相关问题

Analysis on Drug-related Problems of Antibiotics in Clinical Application based on Adverse Drug Reaction/events in Our Hospital

目的:对我院抗菌药物不良反应/事件(ADR/ADE)进行调查分析,探讨我院抗菌药物临床应用的药物相关问题(drug-related problems,DRPs),为我院抗菌药物的临床合理应用提供依据。方法:以我院2015年1月～2018年6月上报的242例抗菌药物相关ADR/ADE为研究对象,探讨其发生特点,同时采用DRPs分类法对抗菌药物使用的必要性、有效性、安全性进行评价研究。结果:242例抗菌药物ADR/ADE病例中,女性多于男性,≥60岁患者占53. 72%;共涉及9大类31个品种的药品,头孢菌素类构成比(47. 93%)最高,左氧氟沙星和环丙沙星所致ADR/ADE病例最多,给药途径以静脉注射为主(94. 63%);严重ADR/ADE 22例(9. 09%)。涉及DRPs具体问题分类有DRP2、DRP3、DRP4、DRP5、DRP6,分别为5例、12例、5例、186例和34例。结论:应重视抗菌药物临床应用的DRPs,预防抗菌药物ADR/ADE的发生,促进抗菌药物安全合理应用。

Objective: Through investigating and analysing the antibiotics adverse reactions/events( ADR/ADE),discussing the drug-related problems( DRPs) in the clinical application of antibacterial drugs,to provide evidence for the clinical rational application of antibacterial drugs in our hospital. Methods: 242 cases of antibiotic ADR/ADE collected from January 2015 to June 2018 in our hospital as the research objects. The occurrence characteristics were discussed,and the clinical effectiveness,necessity,safety of antibacterial-related problems were evaluated using classification method in our hospital. Results: Among the 242 cases of antibiotics ADR/ADE,mainly patients were over 60 years old( 53. 72%);9 categories and 31 varieties of antibiotics were involved. The cephalosporin constituent ratio were highest( 47. 93%),the levofloxacin and ciprofloxacin cases were most resulted from ADR/ADE. The route of administration was mainly intravenous injection( 94. 63%),and severe ADR/ADE was 22 cases( 9. 09%). The specific problems related to DRPs were classified into DRP2( 5 cases),DRP3( 12 cases),DRP4( 5 cases),DRP5( 186 cases),and DRP6( 34 cases). Conclusion: We should pay attention to the DRPs for the clinical application of antibacterial drugs,targeted prevention of ADR/ADE caused by antibacterial drugs,so as to promote the safe and rational application of antibacterial drugs.